{"title":"Inhibitory effects of oestradiol on ferroptosis may underlie sex differences in AKI.","authors":"Ellen F Carney","doi":"10.1038/s41581-025-01013-5","DOIUrl":"https://doi.org/10.1038/s41581-025-01013-5","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"6 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Author Correction: Green nephrology: from evidence to action.","authors":"Katherine A Barraclough,Karin G F Gerritsen","doi":"10.1038/s41581-025-01014-4","DOIUrl":"https://doi.org/10.1038/s41581-025-01014-4","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"100 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PDGFRβ CAR T cells improve fibrosis in kidney disease models.","authors":"Monica Wang","doi":"10.1038/s41581-025-01012-6","DOIUrl":"https://doi.org/10.1038/s41581-025-01012-6","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"73 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145153422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthijs Kox,Michael Bauer,Lieuwe D J Bos,Hjalmar Bouma,Thierry Calandra,Carolyn S Calfee,Benjamin G Chousterman,Lennie P G Derde,Evangelos J Giamarellos-Bourboulis,Hernando Gómez,Mihai G Netea,Marlies Ostermann,Tom van der Poll,Brendon P Scicluna,Christopher Seymour,Manu Shankar-Hari,Nathan Shapiro,Mervyn Singer,Fabienne Venet,Alexander P J Vlaar,Lonneke A van Vught,Sebastian Weis,W Joost Wiersinga,Peter Pickkers
{"title":"The immunology of sepsis: translating new insights into clinical practice.","authors":"Matthijs Kox,Michael Bauer,Lieuwe D J Bos,Hjalmar Bouma,Thierry Calandra,Carolyn S Calfee,Benjamin G Chousterman,Lennie P G Derde,Evangelos J Giamarellos-Bourboulis,Hernando Gómez,Mihai G Netea,Marlies Ostermann,Tom van der Poll,Brendon P Scicluna,Christopher Seymour,Manu Shankar-Hari,Nathan Shapiro,Mervyn Singer,Fabienne Venet,Alexander P J Vlaar,Lonneke A van Vught,Sebastian Weis,W Joost Wiersinga,Peter Pickkers","doi":"10.1038/s41581-025-01004-6","DOIUrl":"https://doi.org/10.1038/s41581-025-01004-6","url":null,"abstract":"Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Treatments that influence this dysregulated host response are sparse. The immunopathophysiology of sepsis entails overzealous inflammation causing acute organ dysfunction, as well as a profound and/or persistent anti-inflammatory response that increases susceptibility to secondary infection. The immune response in sepsis is under the influence of various endogenous and exogenous factors, including genetic makeup, age, sex, comorbidities, metabolism, prior microbial exposure and medications. The consequent heterogeneity of the syndrome hampers immunomodulatory treatment strategies that rely on a 'one-size-fits-all' approach. A precision medicine approach is therefore warranted. Balanced application of prognostic- and predictive-enrichment strategies is instrumental to achieve precision medicine. Phenotyping of patients using clinical, physiological, microbiological and/or molecular ('omics') data enables the identification of more homogeneous patient subgroups. Several studies suggest that such approaches can be used to tailor adjunctive immunomodulatory therapies in patients with sepsis. As well as repurposing existing drugs to treat sepsis, new drugs aimed at restoring immune homeostasis are under investigation. New clinical trial methodologies, including flexible platform trials, Bayesian statistics and embedding trials in health care systems are increasingly being used to keep pace with rapid developments in the field of sepsis immunobiology and ultimately to improve clinical outcomes.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"3 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Griet Glorieux, Stéphane Burtey, Pieter Evenepoel, Joachim Jankowski, Laetitia Koppe, Rosalinde Masereeuw, Raymond Vanholder
{"title":"A guide to uraemic toxicity.","authors":"Griet Glorieux, Stéphane Burtey, Pieter Evenepoel, Joachim Jankowski, Laetitia Koppe, Rosalinde Masereeuw, Raymond Vanholder","doi":"10.1038/s41581-025-01006-4","DOIUrl":"https://doi.org/10.1038/s41581-025-01006-4","url":null,"abstract":"<p><p>When kidney function is compromised, myriad metabolites and peptides - uraemic retention molecules (URMs) - accumulate in the body and compromise homeostasis. Over 150 molecules have been classified as URMs but omics approaches are revealing many more. When URMs exert pathophysiological effects and/or are associated with relevant adverse patient outcomes, they are called uraemic toxins. The origins of uraemic toxins and their contributions to post-translational modification of proteins are important current areas of research. Although most research has thus far focused on uraemic toxins, new studies have also identified URMs with the potential to counteract harmful biological changes that might thus confer a beneficial effect. To tackle the growing burden of chronic kidney disease, preventive therapeutic measures must target the disease early in its course and a balanced view of uraemic retention is needed to understand the role of URMs in kidney disease progression. Knowledge of the origin of the solutes, their kinetics, context-dependent biological profile and the involvement of transporter-mediated interorgan communication by small molecules - termed 'remote sensing and signalling' - is indispensable to facilitate the development of interventions that can promote or restore homeostasis in people with kidney dysfunction.</p>","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":" ","pages":""},"PeriodicalIF":39.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The changing landscape of kidney health and disease in Africa.","authors":"Ifeoma I Ulasi,Ugochi C Onu","doi":"10.1038/s41581-025-01009-1","DOIUrl":"https://doi.org/10.1038/s41581-025-01009-1","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"49 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Guidelines for the use of economic evaluation to inform policies around access to treatment for kidney failure","authors":"Siobhan Botwright, Panji Fortuna Hadisoemarto, Kinanti Khansa Chavarina, Aye Nandar Myint, Brandon Wen Bing Chua, Kridsada Chareonrungrueangchai, Chotika Suwanpanich, Pitsinee Supapol, Ijeoma Edoka, Valerie Luyckx, Martin I. Meltzer, Yot Teerawattananon","doi":"10.1038/s41581-025-01000-w","DOIUrl":"https://doi.org/10.1038/s41581-025-01000-w","url":null,"abstract":"<p>Kidney failure is the most advanced stage of chronic kidney disease, at which point patients require kidney replacement therapy (KRT) in the form of kidney transplant or lifelong dialysis to survive. Although many governments seek to provide KRT for patients with kidney failure under publicly funded health schemes, KRT requires considerable financial and human resources, which may need to be diverted from other health programmes. In deciding which KRT services to provide, to whom, and under which conditions, economic evaluation can show the trade-off between the cost and benefit of different policy options. This Guideline has been written for nephrologists, clinicians and policymakers, to build confidence in requesting, contributing towards, and using the results from economic evaluation studies. It is aimed at outlining the cases in which economic evaluation may support KRT policymaking and to lay out good practice for economic evaluation of KRT services. Recommendations cover the process of developing the policy and research questions, conducting the economic evaluation and interpreting results for policy.</p>","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"33 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah M. L. Young, Roseanne E. Billany, Matthew P. M. Graham-Brown, Courtney J. Lightfoot, Daniel S. March, Alice C. Smith
{"title":"Physical activity in kidney disease: evidence and implementation","authors":"Hannah M. L. Young, Roseanne E. Billany, Matthew P. M. Graham-Brown, Courtney J. Lightfoot, Daniel S. March, Alice C. Smith","doi":"10.1038/s41581-025-00999-2","DOIUrl":"https://doi.org/10.1038/s41581-025-00999-2","url":null,"abstract":"<p>Despite over 30 years of research and guidelines promoting physical activity for people living with chronic kidney disease (CKD), widespread implementation of physical activity in routine care remains low worldwide. Consequently, the population with CKD remains highly inactive across all stages of the disease. Randomized controlled trials in people with CKD, people on dialysis and kidney transplant recipients consistently show that structured exercise is safe and can improve physical function, cardiorespiratory fitness, muscle strength and aspects of quality of life. However, these trials are of variable quality with modest sample sizes in some groups, and a need exists for larger, implementation-focused studies. Evidence generation in CKD has often been disconnected from service development, limiting workforce skills, resources and pathways for delivery. To achieve meaningful change, research must be designed with implementation in mind, using frameworks that consider context, sustainability and stakeholder involvement. Digital solutions and approaches targeting 24-h movement behaviours may extend the reach of physical-activity interventions, but barriers such as health-professional training, patient capability and system-level prioritization must be addressed. Embedding physical activity in clinical care offers a clear opportunity to improve outcomes and quality of life for people living with CKD.</p>","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"100 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Green nephrology: from evidence to action","authors":"Katherine A. Barraclough, Karin Gerritson","doi":"10.1038/s41581-025-01005-5","DOIUrl":"https://doi.org/10.1038/s41581-025-01005-5","url":null,"abstract":"In the past 20 years, awareness of the huge environmental impact of kidney care has increased considerably. Although opportunities to reduce this impact have been identified and innovative approaches developed, implementation of these strategies remains slow. System-wide action is urgently required to improve the sustainability of kidney care.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"9 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}